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Observational Study
. 2023 Dec;18(12):1082-1091.
doi: 10.1002/jhm.13234. Epub 2023 Nov 7.

Impact of a hospital service for adults with chronic childhood-onset disease: A propensity weighted analysis

Colby Feeney  1   2 , Mark Chandler  1   2 , Alyssa Platt  3 , Shifeng Sun  3 , Noppon Setji  1 , David Y Ming  1   2   4
Affiliations
Observational Study

Impact of a hospital service for adults with chronic childhood-onset disease: A propensity weighted analysis

Colby Feeney et al. J Hosp Med. 2023 Dec.

Abstract

Background: Young adults with chronic childhood-onset diseases (CCOD) transitioning care from pediatrics to adult care are at high risk for readmission after hospital discharge. At our institution, we have implemented an inpatient service, the Med-Peds (MP) line, to improve transitions to adult care and reduce hospital utilization by young adults with CCOD.

Objective: This study aimed to assess the effect of the MP line on length of stay (LOS) and 30-day readmission rates compared to other inpatient services.

Methods: This was an observational, retrospective cohort analysis of patients admitted to the MP line compared to other hospital service lines over a 2-year period. To avoid potential confounding by indication for admission to the MP line, propensity score weighting methods were used.

Results: The MP line cared for 302 patients with CCOD from June 2019 to July 2021. Compared to other service lines, there was a 33% reduction in relative risk of 30-day readmission (26.9% compared to 40.3%, risk ratio = 0.67, 95% confidence interval [CI] 0.55-0.81). LOS was 10% longer for the MP line (event time ratio (ETR): 1.10 95% CI 1.0-1.21) with median LOS 4.8 versus 4.5 days. Patients with sickle cell disease had less of a reduction in 30-day readmissions and longer LOS.

Conclusion: Hospitalization for young adults with CCOD on a MP service line was associated with lower 30-day readmission rates and longer LOS than hospitalization on other services. Further research is needed to assess which components of the line most contribute to decreased utilization.

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Conflict of interest statement

Disclosures:

The authors have no conflict of interest.

Figures

Figure 1.
Figure 1.
Patient flow of encounters and patients on Med-Peds (MP) service line and Other services
Figure 2.
Figure 2.
Weighted and unweighted Kaplan Meier curves for length of stay and 30-day hospital readmission for Med-Peds (MP) line and Other Services
See this image and copyright information in PMC

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